Dawaa Reference

acute

Scorpion Sting (Envenomation)

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources4 sources

Scorpion Toxicity - StatPearls, NCBI Bookshelf NBK430928 · Scorpion antivenom versus antivenom plus prazosin, Sohag University Hospitals (PMC11827372) · Egyptian National Drug Formulary - Antimicrobial 2023 · MSF Essential Drugs 2024 - paracetamol (oral)

Verified against3 documents
  • Scorpion Toxicity - StatPearls, NCBI Bookshelf NBK430928
  • MSF Essential Drugs 2024 - paracetamol (oral)
  • Egyptian National Drug Formulary - Antimicrobial 2023

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (5)

  • Most stings cause local swelling, redness, and pain at the site [redness]
  • Sodium-channel toxin effects can cause seizure-like activity, clouding the picture especially when a child cannot give a history [seizures]
  • Overactive throat, diaphragm, and chest-wall muscles can progress quickly to airway collapse, sometimes needing intubation [collapse]
  • Some species cause cardiopulmonary effects: a fast heart rate, pulmonary oedema, and even cardiogenic shock [oedema · shock · tachycardia]
  • Local tissue death can turn up days to weeks after the sting, though this is uncommon [necrosis]

Signs — what you find (2)

  • The sting site typically shows redness with local inflammation, and the patient can often point out the scorpion itself [redness]
  • Numbness and weakness at the site can also be found [numbness]

Tests (2)

  • Basic labs (CBC, metabolic panel, PT/INR, PTT, lipase) are reserved for suspected systemic involvement, mainly severe grade 3 to 4 envenomation
  • Scorpion stings are an uncommon but genuine cause of pancreatitis

If not this — what else fits (3)

  • Botulism, and caterpillar, centipede, or coral snake envenomation can look similar
  • Diphtheria, myasthenia gravis, and pancreatitis are also on the list
  • Ordinary insect bites, organophosphate poisoning, and rattlesnake or redback spider envenomation round out the differential

SourceStatPearls "Scorpion Toxicity" - disease-level clinical article

Presentation findings are traced to the source above.

Rx: Main treatment | Pain | Tetanus prophylaxis

MAIN TREATMENT

1

NO DRUG THERAPY IN PRIMARY CARE (EMERGENCY REFERRAL)

1st line
Adult dose and duration

Any systemic sign - drooling, blurred vision, darting tongue movements, nystagmus, thrashing limbs, an arched back, sweating, vomiting or a fast pulse - is grade 3 or worse. Transfer immediately to a hospital holding VACSERA polyvalent antiscorpion antivenom. Telephone ahead. - Immediate emergency transfer

Paediatric dose

Send every stung child, whatever the grade looks like in the first hour. The same dose of venom into a small body is a higher dose, and the grade can climb while you are watching.

Dose source

Scorpion Toxicity - StatPearls, NCBI Bookshelf NBK430928

Why

The two dangerous species in Egypt are Leiurus quinquestriatus and Androctonus crassicauda. Grade 1 is pain and pins-and-needles at the site; grade 2 is that pain spreading up the limb; grade 3 adds cranial nerve or neuromuscular signs; grade 4 has both and brings hyperthermia, rhabdomyolysis, pulmonary oedema and multi-organ failure. The hospital treatment is VACSERA polyvalent antiscorpion antivenom - 1 mL intramuscularly, or 1 to 5 vials in 5% glucose by infusion depending on severity, reassessed every 4 to 6 hours - and Sohag adds oral prazosin 30 micrograms/kg per dose, maximum 1 mg, four doses six hours apart, patient supine for three hours after the first.

Cautions
  • Grade 1 is pain and pins-and-needles at the sting site and nothing else. Once the tingling has spread up the limb it is grade 2 - keep the patient under observation, do not send them home.
  • Antivenom is not a primary-care drug. Do not spend time trying to find it locally; the transfer is the treatment.
  • Prazosin is a hospital drug here for one reason - the first dose drops the blood pressure, which is why the patient stays supine for three hours after it.
  • Clean the sting site and check tetanus cover on every sting that broke the skin.

PAIN - give alongside

2

PARACETAMOL

Pain

add-on - not a substitute

Strength500 mg

Formoral.solid

Adult dose and duration

1000 mg every 6 hours as needed, maximum 4000 mg in 24 hours x 1-2 days

Paediatric dose

15 mg/kg/dose [child max 500 mg]

(15 mg/kg per dose every 4-6 hours, maximum 60 mg/kg/day. Pain relief on the way to hospital, not a reason to keep the child in the clinic. Under 1 month: 10 mg/kg 3 or 4 times daily, maximum 40 mg/kg/day (MSF Essential Drugs 2024).)

Dose by weight
3kg45 mg/dose
4kg60 mg/dose
5kg75 mg/dose
6kg90 mg/dose
7kg105 mg/dose
8kg120 mg/dose
9kg135 mg/dose
10kg150 mg/dose
11kg165 mg/dose
12kg180 mg/dose
13kg195 mg/dose
14kg210 mg/dose
15kg225 mg/dose
16kg240 mg/dose
17kg255 mg/dose
18kg270 mg/dose
19kg285 mg/dose
20kg300 mg/dose
21kg315 mg/dose
22kg330 mg/dose
23kg345 mg/dose
24kg360 mg/dose
25kg375 mg/dose
26kg390 mg/dose
27kg405 mg/dose
28kg420 mg/dose
29kg435 mg/dose
30kg450 mg/dose
31kg465 mg/dose
32kg480 mg/dose
33kg495 mg/dose
34kg500 mg/dose (capped)
35kg500 mg/dose (capped)
36kg500 mg/dose (capped)
37kg500 mg/dose (capped)
38kg500 mg/dose (capped)
39kg500 mg/dose (capped)
40kg500 mg/dose (capped)
41kg500 mg/dose (capped)
42kg500 mg/dose (capped)
43kg500 mg/dose (capped)
44kg500 mg/dose (capped)
45kg500 mg/dose (capped)
46kg500 mg/dose (capped)
47kg500 mg/dose (capped)
48kg500 mg/dose (capped)
49kg500 mg/dose (capped)
50kg500 mg/dose (capped)
Dose source

MSF Essential Drugs 2024 - paracetamol (oral)

Why

A grade 1 sting in an adult - pain at the site, nothing systemic - is treated with analgesia and observation, and nothing else. Analgesia does not change the grade, so it never replaces the decision to transfer.

Cautions
  • Do not exceed maximum daily dose (risk of severe hepatotoxicity).
  • Check total daily dose from all paracetamol-containing combination products.
  • Reduce the maximum to 3000 mg/day in an adult under 50 kg, malnourished, or with liver disease.
  • 500 mg is the per-dose ceiling used here for a child. 1000 mg is the adult dose and does not belong in a weight calculation - the daily 60 mg/kg limit is the one that binds first in any case.
Egyptian brands
Egyptian brandManufacturerIndicative price
FEBRIMOL 500 MG 20 TAB.PHARCO3.50 EGP (0.17/unit)
CETAMOL 500 MG 20 TABS.MEMPHIS8.00 EGP (0.40/unit)
PARACETAMOL-MUP 500MG B.P. 20 TABS.MUP13.00 EGP (0.65/unit)
CETAL 500 MG 20 TABS.EIPICO24.00 EGP (1.20/unit)
ARKADOLOW 500 MG 30 F.C. TABS.UTOPIA42.00 EGP (1.40/unit)
PARAMOL 500MG 20 TAB.MISR38.00 EGP (1.90/unit)
ADOL 500MG 24 CAPLETSJULPHAR32.00 EGP
AUGICETAMIDE 500 MG 20 SACHETSAUG PHARMA50.00 EGP
FEBRIMOL ORAL DROPS 20 ML? strength differs? different route - not oral solidPHARCO4.00 EGP
THERA-LO 3.2G/100ML ORAL SUSP. 100 ML? strength differs? different route - not oral solidPHAROPHARMA5.00 EGP

TETANUS PROPHYLAXIS - give alongside

3

TETANUS TOXOID

Tetanus prophylaxis

add-on - not a substitute

Forminjection

Adult dose and duration

0.5 mL IM single dose into deltoid muscle - single dose

Paediatric dose

(Children >= 2 months: 0.5 mL IM single dose (usually given as DTaP/Tdap))

Dose by age
2 months and over:0.5 mL IM single dose (usually given as DTaP/Tdap)
Dose source

Egyptian National Drug Formulary - Antimicrobial 2023

Why

Wound cleaning and tetanus prophylaxis are part of the supportive care of any sting that broke the skin.

Cautions
  • A sting is a puncture wound - treat it as tetanus-prone and give a booster if the last dose was more than 5 years ago.
  • Thorough wound cleaning is mandatory.
Egyptian brands

No Egyptian brand matched — prescribe by generic name.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.